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South Florida pharmacists charged in $87 million fraud case linked to former UF player

admin — Tue, 12 May 2020 10:02:41 +0000

Monty Grow, left, during his playing days with the Jacksonville Jaguars. The former Florida Gator was sentenced to 22 years in prison in 2018 in a military-related healthcare fraud case in Miami.

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A couple of years ago, former University of Florida football standout Monty Grow was found guilty of pocketing $18 million in kickbacks for referring military service members and veterans to a local pharmacy that billed the U.S. government for unnecessary medications.

Grow, sentenced to 22 years in prison, has appealed his conviction.

But the federal investigation didn’t end with the ex-NFL player. It got bigger.

Miami prosecutors have charged two former employees with Pompano Beach-based Patient Care America with bilking $87 million from a military healthcare program run by the U.S. Department of Defense. The alleged scheme included patient referrals that Grow and several others steered to them through marketing companies over a one-year span, according to court records.

Matthew Smith, a pharmacist and former vice president of PCA, and Alisa Catoggio, a pharmacy technician, were charged in late April with conspiring to commit healthcare fraud by submitting bogus claims for prescribed drugs to the federal Tricare program for thousands of military service members and veterans who didn’t need them. The former PCA employees are accused of mixing ingredients to create expensive pain creams to treat the scars of military personnel with questionable prescriptions who were not charged any co-payments for the drugs.

The former football player, who owned a marketing firm, used telemedicine companies to prescribe the compound medications, paying them approximately $100 per telephone or video consultation. Grow and his associates filled out prescription forms, faxed them to telemedicine companies for signing by a doctor, and then sent them to the pharmacy.

According to court records, a pain cream prescription that costs the PCA pharmacy about $700 to fill could be reimbursed by Tricare for $16,000. Grow and his team of recruiters received $7,000 in commissions each time.

Of the $87 million that the PCA pharmacy collected from Tricare between 2014 and 2015, about half was kicked back to Grow, his team of associates and other companies for the patient referrals. In addition to healthcare fraud, both Smith and Catoggio are accused of paying and receiving healthcare kickbacks.

Prosecutor Jon Juenger, who handled the Grow case, declined to comment about the expanding pharmacy investigation. Smith’s defense attorney,

Ryan Stumphauzer, a former federal prosecutor who specialized in healthcare fraud cases, said his client “denies the criminal charges and looks forward to vindicating himself in court.”

Catoggio could not be reached for comment.

The Pompano Beach pharmacy business has been mired in controversy over kickback allegations involving the Tricare program for several years. In 2019, Patient Care America, CEO Patrick Smith and and pharmacist Matthew Smith, the former vice president of operations, agreed to settle a False Claims Act case with the Justice Department. PCA, along with a private equity firm, paid $21 million; Patrick Smith paid $300,000; and Matthew Smith paid $12,788. The payments resolving the civil case were based on the ability to pay, according to the Justice Department.

Patrick Smith, the CEO, was not charged criminally. But Matthew Smith, along with his assistant, Catoggio, were charged in the criminal case, which began with the prosecution of Grow and several others.

At Grow’s trial in 2018, the federal jury had to decide whether he intentionally defrauded the military healthcare program or was simply paid lavish but legitimate sales commissions by the pharmacy for referring thousands of patients to Tricare through his marketing company.

Grow’s lawyers urged U.S. District Judge Federico Moreno to be reasonable in his sentencing, which didn’t pan out. They pointed out that eight other defendants in the case — including former University of Florida star and retired NFL quarterback Shane Matthews — received punishment ranging from probation to less than two years. In the conspiracy to fleece the Tricare program, Matthews was sentenced to three months in prison for his bit role on Grow’s marketing team, lining up sales representatives who then landed patients for the PCA pharmacy.

At Grow’s appellate hearing via teleconference last month, his attorney David O. Markus argued that the doctors, not Grow, should be held responsible for the prescriptions. Markus argued that “in every single case a doctor had to approve of the prescription and the doctor was free to change it, alter it or not give it.”

“We have real doctors issuing real prescriptions to real patients who got their medicine,” he told the appellate panel in Atlanta. “Medical necessity was not an issue.”

Contacted by the Miami Herald on Monday, Markus expressed optimism about 48-year-old Grow’s appeal. “Both his conviction and sentence are extremely problematic,” he said.

Jay Weaver writes about bad guys who specialize in con jobs, rip-offs and squirreling away millions. Since joining the Miami Herald in 1999, he’s covered the federal courts nonstop, from Elian’s custody battle to A-Rod’s steroid abuse. He was on the Herald team that won the Pulitzer Prize for breaking news in 2001. He and three Herald colleagues were Pulitzer Prize finalists for explanatory reporting in 2019 for a series on gold smuggled from South America to Miami.

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Second man charged over $3.9 million gold heist

admin — Tue, 12 May 2020 05:30:21 +0000

Mr Kachami is accused of pointing the gun at the head of an employee of the Melbourne Gold Company in Collins Street at 9.40am, before leaving with almost $4 million worth of gold bullion, jewellery and cash.

An employee of the Melbourne Gold Company was allegedly threatened with a gun and assaulted, before the entire contents of a safe were removed with a trolley.

Karl Kachami pictured in Melbourne in 2007.Credit:Angela Wylie

Mr Kachami was charged on April 30 with armed robbery, theft, false imprisonment, assault and two counts of possessing a handgun as a non-prohibited person after police found the loot buried at a rural property near the Gippsland town of Dollar.

Mr Kachami will next face court on July 24.

Police have also searched properties in Hawthorn East and Fitzroy as part of their investigation.

A 48-year-old Hawthorn East woman was also arrested on April 29, however she was released pending further inquiries.

Armed crime squad detectives on Monday released CCTV footage of a vehicle they believe may be connected to the theft.

Police are now searching for the owner of a white Holden Commodore ute that was spotted in Anderson Street, Leongatha, about 1pm on April 30.

The vehicle has black slimline plates with registration beginning with the letters HA.

According to police, the driver was Caucasian in appearance and aged in his early 40s. He was wearing a blue jacket with red on it.

It is believed the man was travelling to the town of Dollar, before he became lost and asked for directions.

The investigation into the incident remains ongoing and anyone with any information urged to contact Crime Stoppers on 1800 333 000 or submit a confidential crime report to www.crimestoppersvic.com.au

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Former Florida football player convicted of $20 million healthcare fraud conspiracy

admin — Wed, 07 Feb 2018 09:13:52 +0000

Monty Grow, a former University of Florida and NFL player who made a small fortune selling pharmaceutical drugs, took the unusual step of testifying in his trial on charges of swindling millions from a federal program that provides medical insurance for the U.S. military.

The 46-year-old Grow was hit again and again with questions by a federal prosecutor about receiving and paying kickbacks to score lucrative patient referrals for a major South Florida pharmacy.

“You were essentially buying and selling patients for a pharmacy?” Assistant U.S. Attorney Jon Juenger pressed Grow.

“No, I was not,” he said calmly.

On Monday, a dozen Miami federal jurors found that they did not believe him.

The jury unanimously convicted Grow of a healthcare fraud conspiracy for bilking $20 million from the TRICARE program for military members, veterans and their families. He was also convicted of conspiring to receive and pay kickbacks for referring hundreds of military beneficiaries to the Pompano Beach-based pharmacy, Patient Care America, as well as of money laundering. But Grow, who remained stoic while the guilty verdicts were read, was acquitted of numerous other related charges.

U.S. District Judge Federico Moreno ordered that Grow, who lives in Tampa, be taken into custody immediately by U.S. marshals because of the amount of money involved in the healthcare fraud case. He faces up to 20 years in prison at his sentencing hearing on April 16.

The jury, which was given instructions on kickbacks and other legal issues by Moreno at the end of the six-day trial, had to decide whether Grow intentionally defrauded the government program or was simply paid lavish but legitimate commissions by the pharmacy for referring the TRICARE patients.

“We are disappointed with the verdict,” Grow’s defense attorneys, Daniel Rashbaum and Jeffrey Marcus, said. “We think that the acquittal on more than half of the counts after four days of deliberation is inconsistent with the result and makes little sense. We will continue to fight for Mr. Grow, who is an innocent man.”

Grow was accused in a 49-count indictment of hiring an independent marketing team — including former University of Florida star and retired NFL quarterback Shane Matthews — in the conspiracy to fleece the TRICARE program.

Last week, Matthews, 47, who played with the Chicago Bears, Miami Dolphins and other teams over a 14-year pro career, was sentenced to three months in prison for his bit role working for Grow’s marketing company. Matthews was paid $440,000 for lining up sales representatives who then landed TRICARE patients for the pharmacy.

Grow and his network of sales representatives referred about 700 patients to Patient Care America, which received $40 million from the government program for supplying costly pain and scar creams along with wellness vitamins between 2014 and 2015. For those referrals, PCA paid half of those federal reimbursements to Grow under a contract agreement. With his cut of the taxpayer funds, Grow kept $10 million for himself and paid out the rest in kickbacks to his marketing associates who recruited TRICARE patients. The sales representatives acted as independent contractors, akin to Avon or Mary Kay reps.

Eventually, Grow himself went from being an independent contractor to a full-time employee for Patient Care America, which factored into his acquittals on numerous kickback charges.

At trial, prosecutors said many of the military members who were referred by his marketing network to Patient Care America did not need the costly compounds, which are specially mixed medications unlike typical commercial drugs. Many only agreed to buy the compound medications because Grow and his sales team paid kickbacks to the patients, who also referred other family members to the pharmacy. Prosecutors said Grow’s team covered patients’ expensive co-payments for the creams and vitamins. One sales representative even paid her stable of patients $1,000 each for filling out a customer survey after receiving their medications from the pharmacy.

The 2016 indictment accusing Grow of conspiracy, fraud, kickbacks and money laundering did not charge Patient Care America or any of its top executives — though prosecutors described them at trial as “unindicted co-conspirators.”

Throughout the trial, prosecutors portrayed Grow as a clever salesman driven by greed who knew he was breaking the law while he pocketed $13,500 for each of the patients that his marketing company referred to the Broward County pharmacy. He owns a Tampa waterfront home, a Range Rover, a Porsche 911 and has millions in an e-trade stock market account.

“This was a pyramid scheme,” Assistant U.S. Attorney Kevin Larsen told the 12-person jury during closing arguments last week. “He took advantage of these folks and he made millions. … The bottom line is, these people signed up because they were paid [kickbacks].”

Grow’s defense attorneys, Rashbaum and Marcus, depicted the former football player as a lawful, successful businessman whose NFL career as a cornerback was cut short by injury in 1996 after playing for the Kansas City Chiefs and Jacksonville Jaguars. They said he began a marketing career in the field of compound pharmacies and later broke out on his own with a Tampa company called MGTEN — his initials and jersey number as a ballplayer.

The defense argued that Grow set up his network of sales representatives to handle hundreds of TRICARE patients and arrange for them to see doctors through “telemedicine” companies. Grow paid the physicians for legitimate consultations, and they approved the vast majority of prescriptions for the compound medications provided by Patient Care America. The defense also said Grow paid his independent contractors “commissions” — not kickbacks — for finding the TRICARE patients.

Grow stood trial alone because an associate with whom he shared millions in kickbacks for the patient referrals pleaded guilty in early January to a conspiracy to commit healthcare fraud. Ginger Lay faces up to 10 years in prison but could receive less time for testifying against her former boss.

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